Claim Brenner, Jesse A.
CLAIM AGAINST THE CITY OF DUBUQUE, IOWA
This written report constitutes your claim against the City of Dubuque, Iowa. You should
complete this form in full and attach any additional information that supports your claim.
The Claim must be filed with the City Clerk at City Hall, 50 W. 13th St., Dubuque, IA 52001.
It will then be referred by the City Council to the appropriate department for investigation.
Once that investigation is completed, a report and recommendation will be submitted to the
City Council. You will be provided with a copy of that report and recommendation.
THE FINAL DECISION ON ALL CLAIMS IS MADE BY THE CITY COUNCIL. NO EMPLOYEE
OF THE CITY OF DUBUQUE HAS THE AUTHORITY TO MAKE ANY REPRESENTATION TO
YOU AS TO WHETHER YOUR CLAIM WILL OR WILL NOT BE PAID.
1. Name of Claimant: Jesse A. Brenner
2. Address: 675 Jefferson Street, Dubuque, IA 52001
3. Telephone Number: 563/557-8197
4. Date of Incident: 05/01/04
5. Time of Incident: A little before 2: 00 pm; 2: 12 pm according to the Investiqating
Offlcer's Report of Motor Vehlcle Accident.
6. Location of Incident (Be specific): Alley behind 2212 Francis Street
7. DESCRIBE ACCIDENT OR OCCURRENCE THAT CAUSED INJURY OR DAMAGE. (Give
full details upon which you base your claim. If a City employee was involved, give the
employee's name.) Officer Russ Stecklein was driving down the alley behind
2212 Francis Street, approximately 25 mph, while Jesse Brenner was riding
his bike in said alley. The witnesses listed below, other than the Claimant's
father, heard Officer Stecklein say to Officer Baker that he was not looking
where he was going. Jesse Brenner attempted to swerve when he saw Officer
Stecklein, but was unable to. Officer Stecklein did not stop his vehicle until
Jesse'e front wheel was caught between both wheels of the Officer's Expedition.
8. What were weather conditions like? Good
9. Give name and address of any witnesses: Father, William Brenner, 2212 Francis
Street, Dubuque, IA 52001; Brother, Austin Brenner, 675 Jefferson, Dubuque
IA 52001; and Kristin Vanderhart, 2212 Francis Street, Dubuque, IA 52001.
10. Did police Investigate? (If so, give names of officers.)
Officer Ed Baker
11. Was anyone injured? (If so, give names, addresses, and extent of Injuries).
Yes, Jesse A. Brenner, 675 Jefferson Street, Dubuque, IA 52001,
Head (mouth) Injury.
12. Was any damage done to property? (If so, describe property and the extent of damages.
Attach estimates of damages or describe basis for ascertaining extent of damage.)
20" Dirt Bike.
Officer Stecklein ran over the bike, crushing it completely.
More specifically, the sproket is broke, bent both wheels, bent front forks,
snapped the axel of the front wheel well.
13. What other damages do you claim, if any? None.
14. Have you been compensated for any part or all of your claim by any insurance
company? (If so, give name and address of insurance company and amount paid.)
No
15. What amount do you claim from the City of Dubuque? Any and all medical bills,
any and all lawyers fees, damages of bicycle.
16. Why do you claim the City of Dubuque is responsible? Officer Stecklein was not
paying attention while he was driving in excess of the speed limit of any
alley, failing to yield until the bike was under the wheel well, and careless
driving.
17. Have you made any claim against anyone else for damages as a result of this incident?
(If yes, give name and address.)
No.
18. If the answer to Question 17 is yes, have you received any payment from that source,
and if so, in what amount?
N A
6
day of
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uart G. Hoover, #9210
Blair & Fitzsimmons, P.C.
850 White Street
Dubuque, IA 52001-7035
Phone: (563) 588-1970
Fax: (563) 556-4033
E-mail: DubuqueLaw @ aol.com
ATTORNEY FOR CLAIMANT
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(Signature)
William Brenner, Father,..,J( Je¡~e ~.
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(Rev. 1/00 & 7/01)
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